Combined effect of fluoride varnish to Er:YAG or Nd:YAG laser on permeability of eroded root dentine

ObjectiveThis study evaluated the combined effect of fluoride varnish to Er:YAG or Nd:YAG laser on permeability of eroded root dentine.DesignSixty slabs of bovine root dentine (2 × 2 × 2 mm) were eroded with citric acid 0.3% (pH 3.2) during 2 h and then kept in artificial saliva during 24 h. Specimens were randomly assigned in 6 groups (n = 10), to receive the following treatments: fluoride varnish; fluoride varnish + Er:YAG laser; fluoride varnish + Nd:YAG laser; non-fluoride varnish; non-fluoride varnish + Er:YAG laser; non-fluoride varnish + Nd:YAG laser. The Er:YAG (100 mJ, 3 Hz) and Nd:YAG (70 mJ, 15 Hz) were applied for 10 s. Specimens were subjected to further erosive challenges with citric acid 0.3% 4×/day, during 1 min, for 5 days, remaining in artificial saliva between cycles. Dentin permeability was then assessed. Two-way ANOVA demonstrated no significant interaction between laser and varnish (p = 0.858).ResultsNo effect was also detected for the main factor varnish (p = 0.768), while permeability of eroded root dentin was significantly lower when such substrate was laser-irradiated, no matter the laser source (p < 0.001).ConclusionsThis study concluded that Er:YAG and Nd:YAG lasers can be employed to control the permeability of eroded root dentin, regardless of fluoride varnish application.     

Sodium fluoride effect on erosion–abrasion under hyposalivatory simulating conditions

ObjectivesTo investigate the effect of fluoride (0, 275 and 1250 ppm F; NaF) in combination with normal and low salivary flow rates on enamel surface loss and fluoride uptake using an erosion–remineralization–abrasion cycling model.DesignEnamel specimens were randomly assigned to 6 experimental groups (n = 8). Specimens were individually placed in custom made devices, creating a sealed chamber on the enamel surface, connected to a peristaltic pump. Citric acid was injected into the chamber for 2 min followed by artificial saliva at 0.5 (normal flow) or 0.05 (low flow) ml/min, for 60 min. This cycle was repeated 4×/day, for 5 days. Toothbrushing with abrasive suspensions containing fluoride was performed for 2 min (15 s of actual brushing) 2×/day. Surface loss was measured by optical profilometry. KOH-soluble fluoride and enamel fluoride uptake were determined after the cycling phase. Data were analysed by two-way ANOVA.ResultsNo significant interactions between fluoride concentration and salivary flow were observed for any tested variable. Low caused more surface loss than normal flow rate (p < 0.01). At both flow rates, surface loss for 0 was higher than for 275, which did not differ from 1250 ppm F. KOH-soluble and structurally-bound enamel fluoride uptake were significantly different between fluoride concentrations with 1250 > 275 > 0 ppm F (p < 0.01).ConclusionsSodium fluoride reduced enamel erosion/abrasion, although no additional protection was provided by the higher concentration. Higher erosion progression was observed in low salivary flow rates. Fluoride was not able to compensate for the differences in surface loss between flow rates.     

Multiple correlations of material parameters of light-cured dental composites

ObjectivesThe aim of this study was to explore the correlations between the Knoop hardness, Young's modulus, viscosity, and polymerization shrinkage of an experimental dental composite, in order to determine the temporal variations of the material properties during the polymerization process.MethodsThe digital image correlation method was employed to measure the polymerization shrinkage along the curing depth of bar-shape specimens (cross-section 4 mm × 2 mm and length 10 mm) of an experimental composite RZE045. The shrinkage data were correlated with the Knoop microhardness measured on specimens prepared in consistent conditions. Another series of tests were performed on cuboid composite samples (cross-section 4 mm × 4 mm and height 5 mm) with different degrees of conversions to determine the correlations among microhardness, Young's modulus and viscosity. Further correlations between shrinkage, Young's modulus and viscosity were then derived, from which the temporal variations of the mechanical parameters during curing were estimated.ResultsAlong the curing depth, the Knoop microhardness of the experimental composite RZE045 decreased more rapidly than its volumetric shrinkage. A power function was employed to describe their relation. On the other hand, Knoop microhardness was found to be proportional to Young's modulus and viscosity. These linear correlations also seemed to be applicable to other materials including unfilled resins, silica glass and other dental composites.SignificanceCorrelations between material parameters of dental composites allowed the rapid temporal variations of Young's modulus and viscosity during curing to be estimated based on the measured polymerization shrinkage-strain history.     

Rinsing with antacid suspension reduces hydrochloric acid-induced erosion

ObjectiveMouthrinsing with antacids, following erosive episodes, have been suggested as a preventative strategy to minimize tooth surface loss due to their neutralizing effect. The purpose of this in situ study was to evaluate the effect of an antacid suspension containing sodium alginate, sodium bicarbonate and calcium carbonate in controlling simulated erosion of enamel of intrinsic origin.DesignThe experimental units were 48 slabs (3 × 3 × 2 mm) of bovine enamel, randomly divided among 12 volunteers who wore palatal appliances with two enamel slabs. One of them was exposed extra-orally twice a day to 25 mL of a hydrochloric acid (HCl) solution (0.01 M, pH 2) for 2 min. There were two independent phases, lasting 5 days each. In the first phase, according to a random scheme, half of the participants rinsed with 10 mL of antacid suspension (Gaviscon^®, Reckitt Benckiser Healthcare Ltd.), while the remainder was rinsed with deionized water, for 1 min. For the second phase, new slabs were inserted and participants switched to the treatment not received in the first stage. Therefore, the groups were as follows: (a) erosive challenge with HCl + antacid suspension; (b) erosive challenge with HCl + deionized water (DIW); (c) no erosive challenge + antacid suspension; (d) no erosive challenge + DIW. Specimens were assessed in terms of surface loss using optical profilometry and Knoop microhardness. The data were analyzed using repeated measures two-way analysis of variance and Tukey’s tests.ResultsCompared to DIW rinses, surface loss of enamel was significantly lower when using an antacid rinse following erosive challenges (p = 0.015). The Knoop microhardness of the enamel was significantly higher when the antacid rinse was used (p = 0.026).ConclusionsThe antacid suspension containing sodium alginate, sodium bicarbonate and calcium carbonate, rinsed after erosive challenges of intrinsic origin, reduced enamel surface loss.     

Effect of fluoride toothpaste with nano-sized trimetaphosphate on enamel demineralization: An in vitro study

ObjectiveThis study evaluated the effect of toothpastes containing 1100 ppm F associated or not with micrometric or nano-sized sodium trimetaphosphate (TMP) on enamel demineralization in vitro, using a pH cycling model.DesignBovine enamel blocks (4 mm × 4 mm, n = 96) were randomly allocated into eight groups (n = 12), according to the test toothpastes: Placebo (without fluoride or TMP); 1100 ppm F (1100F); 1100F plus micrometric TMP at concentrations of 1%, 3% or 6%; and 1100F plus nanosized TMP at 1%, 3% or 6%. Blocks were treated 2×/day with slurries of toothpastes and submitted to a pH cycling regimen for five days. Next, final surface hardness (SHf), integrated hardness loss (IHL), differential profile of integrated hardness loss (ΔIHL) and enamel fluoride (F) concentrations were determined. Data were analyzed by ANOVA and Student-Newman-Keuls’ test (p < 0.05).ResultsThe use of 1100F/3%TMPnano led to SHf 30% higher (p < 0.001) and IHL ∼ 80% lower (p < 0.001) when compared to 1100F. This toothpaste also resulted in ∼64% reduction of mineral loss (ΔIHL) when compared to 1100F. Moreover, the addition of nano-sized TMP promoted increases in enamel F uptake of 90%, 160% and 100%, respectively for the concentrations of 1%, 3% and 6%, when compared to 1100F (p < 0.001).ConclusionThe addition of nano-sized TMP at 3% to a conventional toothpaste significantly decreased enamel demineralization when compared to its counterparts without TMP or supplemented with micrometric TMP.     

Recharge and increase in hardness of GIC with CPP-ACP/F

ObjectiveTo assess the effect of CPP-ACP/F recharging on ion release and hardness of GIC Fuji-Triage (VII) and Fuji-Triage-EP (VII-EP) containing CPP-ACP/F.MethodsCPP-ACP distribution in Fuji-Triage-EP was determined using immunofluorescence. Thirty blocks of Fuji-Triage and Fuji-Triage-EP with the same surface area were placed individually in 5 mL of 50 mM lactic acid (pH 5) for three days. Every 12 h ten Fuji-Triage and ten Fuji-Triage-EP blocks were treated with 2 mL of either MI Paste Plus (CPP-ACP/F) solution (1 g paste + 4 mL water), Placebo MI paste solution (no CPP-ACP/F), or distilled water for 2 min. After each 2 min treatment the blocks were rinsed with distilled water and placed back into the acid. Calcium, inorganic phosphate and fluoride levels in the acid solution were measured using atomic absorption spectrophotometry, colorimetry and ion specific electrode respectively. Vickers surface hardness of the GIC was also determined. Data were analysed using a two-sample t-test and one-way ANOVA with a Bonferroni-Holm correction for multiple comparisons.ResultsCPP-ACP was distributed throughout Fuji-Triage-EP. Significantly (p < 0.001) higher calcium, inorganic phosphate and fluoride ion release and greater surface hardness (acid resistance) was observed in both GIC’s treated with the CPP-ACP/F paste. Fuji-Triage-EP released higher ion levels and exhibited greater surface hardness (acid resistance) than Fuji-Triage.SignificanceTopical application of CPP-ACP/F paste to GIC Fuji-Triage-EP recharged ion release and increased surface hardness (acid resistance) which may help improve properties and resistance to degradation as well as improve ion release for caries control.     

Effect of storage in artificial saliva and thermal cycling on Knoop hardness of resin denture teeth

PurposeThis study aimed to evaluate the effect of different storage periods in artificial saliva and thermal cycling on Knoop hardness of 8 commercial brands of resin denture teeth.MethodsEigth different brands of resin denture teeth were evaluated (Artplus group, Biolux group, Biotone IPN group, Myerson group, SR Orthosit group, Trilux group, Trubyte Biotone group, and Vipi Dent Plus group). Twenty-four teeth of each brand had their occlusal surfaces ground flat and were embedded in autopolymerized acrylic resin. After polishing, the teeth were submitted to different conditions: (1) immersion in distilled water at 37 ± 2 °C for 48 ± 2 h (control); (2) storage in artificial saliva at 37 ± 2 °C for 15, 30 and 60 days, and (3) thermal cycling between 5 and 55 °C with 30-s dwell times for 5000 cycles. Knoop hardness test was performed after each condition. Data were analyzed with two-way ANOVA and Tukey's test (α = .05).ResultsIn general, SR Orthosit group presented the highest statistically significant Knoop hardness value while Myerson group exhibited the smallest statistically significant mean (P < .05) in the control period, after thermal cycling, and after all storage periods. The Knoop hardness means obtained before thermal cycling procedure (20.34 ± 4.45 KHN) were statistically higher than those reached after thermal cycling (19.77 ± 4.13 KHN). All brands of resin denture teeth were significantly softened after storage period in artificial saliva.ConclusionStorage in saliva and thermal cycling significantly reduced the Knoop hardness of the resin denture teeth. SR Orthosit denture teeth showed the highest Knoop hardness values regardless the condition tested.     

Inhibition of enamel mineral loss by fissure sealant: An in situ study

ObjectivesThis study evaluated the effect of fluoride and non-fluoride sealants on hardness decrease (HD) and marginal adaptation (MA) on enamel substrates after cariogenic challenge.MethodsOcclusal enamel blocks, from human third molars, were randomly divided into six groups (n = 12), according to occlusal fissures condition (S – sound; C – caries-like lesion; CF – caries-like lesion + topical fluoride) and sealants (F – FluroShield; H – Helioseal Clear Chroma). Lesion depths were 79.3 ± 33.9 and 61.3 ± 23.9 for C and CF groups, respectively. Sealants were placed on occlusal surface and stored at 100% humidity (37 °C; 24 h/d). HD was measured by cross-sectional microhardness analysis at the sealant margin distances: ?1 (under sealant), 0 (sealant margin), 1, 2 (outer sealant). Sealant MA was observed by polarized light microscopy and scored according to: 0 – failure (no sealant MA or total sealant loss); 1 – success (sealant MA present). MA and HD were analysed by ANOVA-R and mixed model analysis, respectively.ResultsFor HD (ΔS), F values (6900.5 ± 3686.6) were significantly lower than H values (8534.6 ± 5375.3) regardless of enamel substrates and sealant margin distances. Significant differences were observed among sealant margin distances: ?1 (5934.0 ± 3282.6) < 0 (8701.5 ± 6175.7) = 1 (8473.2 ± 4299.4) = 2 (7761.5 ± 4035.1), regardless of sealant and substrate. MA was similar for all groups (p ≥ 0.05).ConclusionMA was not affected by sealant type or substrate condition, whereas enamel HD was favourably impacted by fluoride in the sealant. In addition, sealants were more effective as a physical barrier than as its chemical potency in reducing enamel HD.Clinical significanceSealing with a fluoride material is a recommended procedure to prevent caries of occlusal permanent molars in high-caries-risk patients, even though those exhibiting white spot lesions, since the enamel hardness decrease when fluoride sealant was used in vitro.     

Fluoride released from glass-ionomer cement is responsible to inhibit the acid production of caries-related oral streptococci

ObjectivesGlass-ionomer cements (GICs) are known to have inhibitory effects on bacterial growth, but the biochemical mechanism of this property has not been fully understood. This study aimed to evaluate inhibitory effects of GIC on the acid production of caries-related oral streptococci, and to identify the components responsible for the inhibition.MethodsAn eluate was prepared by immersing set GIC in phosphate-buffered saline at 37 °C for 24 h. Fluoride and other elements in the eluate were quantified by fluoride ion electrode and atomic absorption photometry, respectively. Streptococcus mutans NCTC 10449 and Streptococcus sanguinis NCTC 10556 were used to evaluate the pH fall and the rate of acid production after the addition of glucose in the presence or absence of the eluate. Acidic end products from glucose were also assayed by carboxylic acid analyzer.ResultsThe eluate contained silicon (1.24 ± 0.26 mM), fluoride (0.49 ± 0.02 mM) and aluminum (0.06 ± 0.00 mM), and inhibited the pH fall and the acid production rate of both streptococci at acidic pH, with a concomitant decrease in lactic acid production. These effects were comparable to those of a potassium fluoride solution containing the same concentration of fluoride as the eluate.SignificanceThese results indicate that the GIC eluate inhibits the acid production of caries-related oral streptococci at acidic pH and that the effect is due to fluoride derived from the GIC. Thus, adjacent to GIC fillings, bacterial acid production and the subsequent bacterial growth may decrease, establishing a cariostatic environment.     

The effect on dental enamel of varying concentrations of fluoridated milk with a cariogenic challenge in situ

ObjectivesThis study investigated the effect of two concentrations of fluoride in milk, 2.5 and 5.0 ppm, on the prevention of demineralisation with a cariogenic challenge compared with milk with 0 ppm F.MethodsIn a controlled, randomised, cross-over, double-blind in situ study, 23 subjects wore a lower removable appliance with 2 enamel slabs for 21 days during each study arm. Subjects used F-free toothpaste and the cariogenic challenge comprised of five 2 min dippings per day in 12% sucrose. The slabs were dipped in 50 ml of milk with 0 ppm, 2.5 ppm or 5.0 ppm F twice daily for 5 min. Subjects drank 100 ml twice per day of the same milk. Slabs were analysed with Knoop microhardness to assess changes in mineralisation.ResultsResults showed that enamel was softened in all groups but the extent of enamel softness was reduced with an increasing concentration of F in milk, being highly significant for both F groups compared to the control (p < 0.0001). 5.0 ppm F group showed a trend towards less softening compared to the 2.5 ppm F but was not statistically significant.ConclusionsIn our in situ model, 2.5 and 5.0 ppm F in milk significantly protected enamel from demineralisation.     

In vitro dentine remineralization with a potential salivary phosphoprotein homologue

ObjectiveAdvantages of introducing a salivary phosphoprotein homologue under standardized in vitro conditions to simulate the mineral-stabilizing properties of saliva have been proposed. This study longitudinally investigates the effects of casein, incorporated as a potential salivary phosphoprotein homologue in artificial saliva (AS) solutions with/without fluoride (F) on in vitro dentine lesion remineralization.DesignThin sections of bovine root dentine were demineralized and allocated randomly into 6 groups (n = 18) having equivalent mineral loss (ΔZ) after transverse microradiography (TMR). The specimens were remineralized using AS solutions containing casein 0 μg/ml, F 0 ppm (C₀–F₀); casein 0 μg/ml, F 1 ppm (C₀–F₁); casein 10 μg/ml, F 0 ppm (C₁₀–F₀); casein 10 μg/ml, F 1 ppm (C₁₀–F₁); casein 100 μg/ml, F 0 ppm (C₁₀₀–F₀) or casein 100 μg/ml, F 1 ppm (C₁₀₀–F₁) for 28 days with TMR taken every 7 days.ResultsSurface mineral precipitation, evident in group C₀–F_1, was apparently inhibited in groups with casein incorporation. Repeated measures ANOVA with Bonferroni correction revealed higher ΔZ for non-F and non-casein groups than for their counterparts (p < 0.001). Subsequent multiple comparisons showed that mineral gain was higher (p < 0.001) with 10 μg/ml casein than with 100 μg/ml when F was present in the earlier stages of remineralization, with both groups achieving almost complete remineralization after 28 days.ConclusionCasein is a potential salivary phosphoprotein homologue that could be employed for in vitro dentine remineralization studies. Concentration related effects may be clinically significant and thus must be further examined.     

The effect of temperature and ionic solutes on the fluoride release and recharge of glass-ionomer cements

ObjectiveTo determine the effect of storage temperature and the presence of sodium chloride in solution on the fluoride uptake and release of glass-ionomer cements.MethodsSeveral commercial brands were used, and stored at either room temperature (21–23 °C) or 37 °C, in KF solution at a concentration of 1000 ppm F⁻ with and without 0.9% NaCl present. Fluoride levels in the storage solutions after 24 h were measured using a fluoride-ion selective electrode. Specimens were then stored in water, and fluoride release after 24 h was determined. Studies were also carried out to determine chloride levels when specimens were stored in 0.9% NaCl, with or without 1000 ppm fluoride, again using an ion selective electrode.ResultsAll glass-ionomer specimens took up fluoride, and most of the fluoride was retained over the next 24 h when the specimens were stored in water. There was a slight variation in the amount of fluoride taken up with storage temperature and with the presence of sodium chloride. All specimens also took up chloride, with greater uptake at higher temperatures, but little or no effect when KF was also present in solution.SignificanceThe substantial retention of fluoride after 24 h in deionised water confirms previous findings and suggests that an insoluble species, possibly SrF₂, forms in situ. Chloride uptake has not been reported previously, and its significance requires further investigation. Fluoride and chloride uptake were apparently independent of each other, which suggests that the ions are taken up at different sites in the cement. This may relate to differences in the respective sizes and hydration states of F⁻ and Cl⁻ ions.     

Effect of low pH on surface rehardening efficacy of high concentration fluoride treatments on non-cavitated lesions

ObjectiveProfessionally applied acidulated phosphate fluoride has been shown to reduce caries incidence. However, it has been suggested that its efficacy might be reduced in advanced non-cavitated lesions. This study aimed to compare the surface rehardening and fluoride uptake effect of 2%-NaF solutions at different pH on non-cavitated caries-like lesions with two different levels of demineralization.MethodsHuman enamel specimens were demineralized to create early and advanced non-cavitated lesions. Specimens for each type of lesion were divided into 3 groups, treated for four minutes with either 2%-NaF pH 3.5, 2%-NaF at pH 7.0, or neutral deionized water, and exposed to a pH cycling remineralization/demineralization model for five days. An additional treatment was then done as described above followed by five more days of cycling (total of 2 treatments, ten-day pH cycling). Specimens were analyzed for surface microhardness change and fluoride uptake.ResultsIt was found that for both types of lesions, acidic pH fluoride treatment was significantly (p < 0.05) more effective than neutral pH treatment in rehardening the lesion surface and promoting fluoride uptake. Furthermore, the low pH vs neutral pH difference in rehardening was significantly larger in the less demineralized lesions (p = 0.0001). Water treatment resulted in no rehardening or fluoride uptake.ConclusionsResults from this study suggest that high concentration fluoride treatments at acidic pH are more effective in rehardening the surface of non-cavitated caries lesions and promoting fluoride uptake than those at neutral pH. This effect appears to be greater in less demineralized lesions when compared to more advanced ones.Clinical significanceThe results of this investigation suggest that when no other attenuating circumstances are present (e.g., the possibility of damaging tooth-coloured restorations), high concentration fluoride treatments for high risk individuals might be more efficacious using products at low pH.     

An in situ caries study on the interplay between fluoride dose and concentration in milk

Objectives

This randomized, cross-over in situ study investigated the impact of sodium fluoride dose and concentration in milk on caries lesion rehardening, fluoridation and acid resistance.

Methods

Twenty-eight subjects wore two gauze-covered enamel specimens with preformed lesions placed buccally on their mandibular partial dentures for three weeks. Participants used fluoride-free dentifrice throughout the study and consumed once daily one of the five study treatments: no fluoride in 200 ml milk (0F-200), 1.5 or 3 mg fluoride in either 100 (1.5F-100; 3F-100) or 200 ml milk (1.5F-200; 3F-200). After three weeks, specimens were retrieved. Knoop hardness was used to determine rehardening and resistance to a secondary acid challenge. Enamel fluoride uptake (EFU) was determined using a microbiopsy technique.

Results

A linear fluoride dose–response was observed for all study variables which exhibited similar overall patterns. All the treatments resulted in rehardening, with 0F-200 inducing the least and 3F-100 the most. Apart from 1.5F-200, all the treatments resulted in statistically significantly more rehardening compared to 0F-200. The fluoride doses delivered in 100 ml provided directionally although not statistically significantly more rehardening than those delivered in 200 ml milk. EFU data exhibited better differentiation between treatments: all fluoridated milk treatments delivered more fluoride to lesions than 0F-200; fluoride in 100 ml demonstrated statistically significantly higher EFU than fluoride in 200 ml milk. Findings for acid resistance were also more discerning than rehardening data.

Conclusions

The present study has provided further evidence for the anti-caries benefits of fluoridated milk. Both fluoride dose and concentration appear to impact the cariostatic properties of fluoride in milk.     

Effect of laser activated bleaching on the chemical stability and morphology of intracoronal dentin

ObjectivesTo evaluate the effect of the bleaching with 35% hydrogen peroxide either activated or not by a 970 nm diode laser on the chemical stability and dentin surface morphology of intracoronary dentin.MethodsTwenty-seven slabs of intracoronary dentin specimens (3 × 3 mm) were distributed into three groups (n = 9), according to surface treatment: HP – 35% hydrogen peroxide (1 × 4’), DL – 970 nm diode laser (1 × 30”/0,8W/10 Hz), HP + DL – 35% HP activated with 970 nm diode laser (1 × 30”/0,8W/10 Hz leaving the gel in contact to the surface for 4′ after activation). Three Raman spectra from each fragment were obtained to calculate the mean intensity of peaks of inorganic component (a.u.), organic collagen content (a.u.), and the ratio of inorganic/organic content, before and after treatment. Analyses of the samples by confocal laser microscopy were performed to evaluate the surface roughness, percentage of tubules, perimeter and area percentage of tubules, before and after treatment. Data were analyzed by Kruskal-Wallis, Dunn’s, and Wilcoxon test (P < 0.05).ResultsData analysis showed that HP + DL did not change the inorganic content peaks 8.31 [29.78] or the inorganic/organic ratio 3.37 [14.67] (P > 0.05). Similarly, DL did not affect the chemical stability of the dentin surface (P > 0.05). However, HP significantly increased inorganic content peaks 10.87 [22.62], as well as the inorganic/organic ratio 6.25 [27.78] (P < 0.05). Regarding the morphological alterations, all surface treatments increase tubules exposure; HP treatment significantly increases perimeter and area percentage; and HP + DL increases surface roughness.ConclusionsBleaching HP combined with DL offers an improvement in terms of intracoronal dentin surface protection, yielding better maintenance of dentin chemical stability and morphology.     

Effect of application sequence of fluoride and CPP-ACP on remineralization of white spot lesions in primary teeth: An in-vitro study

ObjectiveTo explore how application sequence of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride influences remineralization of enamel white spot lesions (WSL) in primary teeth.DesignIn this in-vitro study, artificial WSLs were created in 130 primary teeth. Teeth were divided into 4 groups (n = 27) and a control group (n = 22) and exposed to one of the following remineralization regimens for 10 weeks: Group-1; 500 ppm fluoride dentifrice; Group-2; 10% w/v CPP-ACP; Group-3; fluoride applied first, then CPP-ACP; Group-4; CPP-ACP applied first, then fluoride, and Group-5 was control. All groups were kept in a remineralizing solution. Mineral changes (ΔF) were quantified weekly using quantitative light-induced fluorescence. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS version 20.0).ResultsRemineralization occurred in all groups to different degrees; changes from baseline were significant in groups 1–4 (P ≤ 0.05). Group-4 showed the earliest significant remineralization (after 2 weeks) among groups, (P < 0.001). Group-4 showed maximum changes in ΔF among groups; however, only differences with Groups 1 and 5 were significant (P < 0.05 and P < 0.01, respectively). Group-3 showed better remineralization than Groups 1, 2 and 5; however, the difference was only significant with Group-5 (P < 0.001). There were no significant differences between Group 1and 2, however, only Group 2 showed better remineralization than Group 5, (P < 0.01).ConclusionCombined treatment with CPP-ACP followed by fluoride exhibited the best remineralization of white spot lesions in primary teeth in this study. Combined treatment with fluoride followed by CPP-ACP showed a tendency towards better remineralization than fluoride or CPP-ACP alone.     

Effects of polyphosphates and fluoride on hydroxyapatite dissolution: A pH-stat investigation

ObjectivesThis study investigated the immediate and sustained effect of sodium trimetaphosphate (TMP) and sodium hexametaphosphate (HMP) associated or not with fluoride (F) on hydroxyapatite (HA) dissolution using an erosion-like model, considering as well as the influence of salivary coating.DesignBaseline dissolution rates were determined for HA discs using a pH-stat system. In the first set of experiments, HA discs were treated with 1100 μg F/mL, 1% or 8% of HMP, 1% or 8% of TMP and 1100 μg F/mL associated with 1% or 8% of HMP or TMP, totaling 9 groups (n = 8). In a second phase, HA discs were kept in pooled human saliva at 37 °C for 2 h before treatment with deionised water and 1100 μg F/mL associated with 1% or 8% of HMP or TMP, totaling 5 groups (n = 8). The post-treatment dissolution rate was determined from three consecutive 30-min assays. Data were analysed using 2 and 3-way ANOVA followed by Fisher and Holm–Sidak methods, respectively (α = 0.05).ResultsAll test solutions promoted reduction in HA dissolution rate when compared to baseline control in the first post-treatment run (p < 0.001). However, a synergistic effect was only observed between fluoride and 1% HMP. Moreover, the duration of inhibitory effect was greater when 8% HMP and 1 or 8% HMP associated with F were assessed (p < 0.001). The presence of salivary coating led to higher protection for all groups when compared to discs without coating (p < 0.001).ConclusionThe reduction of HA dissolution rate, as well as the duration of this effect were influenced by fluoride, type and concentration of phosphate salt and the presence of a salivary coating.     

Effect of proanthocyanidin on ultrastructure and mineralization of dentine collagen

ObjectiveProanthocyanidin (PA) is a natural collagen cross-linker that has been used in dentine matrix biomodification for reparative and preventive therapies. This study evaluated the ultrastructure of collagen after its interaction with PA. Furthermore, the mineralization of PA-biomodified collagen matrix was observed.MethodsTen freshly extracted sound human molars were sectioned into 0.5 mm × 1.7 mm × 7 mm beams for ultrastructural evaluation of PA and dentine matrix under Field Emission Scanning Electron Microscopy (FESEM) and Transmission Electron Microscopy (TEM). Specimens for TEM were completely demineralized and divided into three groups according to PA treatments: deionized water, 2% PA and 6.5% PA. The specimens were fixed, dehydrated, sectioned and examined using TEM. Specimens for FESEM were lightly conditioned with EDTA and similarly divided into the three groups for observation using FESEM. Type I collagen from calf skin was used to analyse the mineral interaction after treatment with 6.5% PA. Formvar- and carbon-coated 400-mesh Ni grids (EMS, Hatfiels, PA, USA) were placed over a 2 mg/mL collagen solution prepared from calf skin-derived Type I collagen to achieve self-assembly of collagen fibrils. Grids were treated with 6.5% PA and divided into two groups. One group was floated over a remineralization solution containing 20 mM HEPES, 2.25 mM CaCl₂-2H₂O, 1.35 mM KH₂PO4, 3.08 mM NaN3 and 130 mM KCl and the other group was over a CPP-ACP solution (Tooth mousse 1:100 dilution with deionized water). The floating samples were kept in a 37 °C and 100% humidity chamber. Grids were taken out at selected time durations (24 h, 48 h and 72 h for mineralization solution/24 h for CPP-ACP) and observed under TEM without staining. Selected area electron diffractions (SAEDs) were performed at 110 kV.ResultsFollowing treatment of demineralized dentine collagen matrix with PA, the size and number of interfibrillar spaces were reduced. The collagen fibrils aggregated together with a reduction in porosity. A characteristic banding pattern of collagen fibrils was observed under TEM. Treatment of PA-biomodified collagen fibrils with remineralization solution increased mineral aggregation along its long axis, when compared to the control group. Furthermore, treatment of PA-biomodified collagen fibrils with CPP-ACP solution enhanced mineral uptake and deposition as well as initiated apatite formation within 24 h.ConclusionProanthocyanidin alters the ultrastructure of demineralized dentine collagen matrix. The PA-biomodified collagen matrix promotes remineralization.     

Frequency of intake and amount of fluoride in milk for remineralisation of artificial caries on enamel and dentine: Ex vivo/in situ study

ObjectivesThis study analysed the effect of frequency of intake and amount of fluoride in milk on the remineralisation of artificial enamel and dentine caries lesions ex vivo/in situ.Materials and methodsPre-demineralised bovine enamel and dentine slabs were randomly allocated into 5 groups and fixed in removable appliances used by subjects for 7 days in each phase. Each treatment comprised milk containing 2.5 ppm fluoride daily (T1), or every other day (T2), 5.0 ppm F daily (T3), or every other day (T4) or no treatment (T5).ResultsEnamel alterations were quantified by surface hardness recovery (%SHR) and transversal microradiography (TMR), and in dentine by TMR only. Data were analysed by ANOVA and Tukey’s test (p < 0.05). For enamel, the highest %SHR was found for T1 and T3 compared to control, without significant differences between them. All groups showed positive values of ΔΔZ − T1 (247.3 ± 198.5); T2 (110.9 ± 303.2); T3 (226.0 ± 299.2); T5 (5.0 ± 288.0), except T4 (−274.5 ± 407.3). For dentine, the only group that presented remineralisation was T2 (350.0 ± 657.5).ConclusionsFluoridated milk daily seems to have higher remineralising effect on enamel than its use every other day. Dentine, does not seem to benefit from daily use of fluoridated milk.     

Oral health,diabetes, and body weight

ObjectivesThe effects of apical periodontitis (AP) and periodontal disease (PD) on organ weights in rats with diabetes mellitus (DM) were evaluated.DesignEighty male rats (Rattus norvegicus albinus, Wistar) were divided into eight groups of ten: normoglycemic (N), AP, PD, AP + PD, DM, DM + AP, DM + PD, and DM + AP + PD. DM was induced by streptozotocin; AP, by dental exposure to the oral environment; and PD, by periodontal ligature. Blood glucose concentration was measured at 0, 6, 15, and 35 days; body weight, measured daily; and animals were sacrificed after 30 days after induction of oral infections. Liver, kidney, pancreas, brain, heart, lungs, and gonads were each weighed. Glycemia, feed intake, organ weight, and body weight were subjected to statistical analyses (p < 0.05).ResultsGlycemic levels were higher in all diabetic groups after day 6, but were consistently similar in normoglycemic groups. Blood glucose was higher in DM + PD and DM + AP + PD groups than in the DM group at days 15 and 35. The feed intake was similar among all groups. Brain, heart, and gonad weights were significantly increased in DM + AP + PD. Kidney and lung weights were increased in DM, regardless of the presence of oral infections. Liver weight was reduced in AP and/or PD. Pancreas weight was reduced in DM, independent of AP or PD. Among the normoglycemic groups, there were no significant differences among organ weights.ConclusionApical periodontitis and periodontal disease may potentiate the adverse effects of diabetes.